Hale Goksever Celik, MD

Dr. Goksever Celik is an obstetrician and gynecologist, graduated from the medical school of the Hacettepe University in Ankara, and trained through Obstetrics and Gynecology fellowship at Dokuz Eylul University in Izmir. She has been a postdoctoral research fellow at Molecular Biology and Genetics at Istanbul University. She has been participating in several research especially interested in the association between endometriosis surgery and ovarian reserve and the genetic basis of endometriosis.

The effect of chronic endometritis on pregnancy outcomes in infertile women having minimal/mild endometriosis

Endometriosis is an estrogen-dependent disease that is frequently diagnosed in reproductive-aged women. Infertility can be associated with endometriosis in these women depending on several pathophysiologic mechanisms such as anatomic distortion, and implantation failure. Thus pregnancy rate is so important, especially in women who underwent an operation for endometriosis. Qiao et al., from China, published a retrospective study titled “Existence of chronic endometritis and its influence on pregnancy outcomes in infertile women with minimal/mild endometriosis” in the International Journal of Gynecology…

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Ankylosing Spondylitis and Endometriosis

There are several theories contributing the development of endometriosis: one of the proposed pathophysiological mechanisms is the abnormality in immune and inflammatory system. Several immunologic diseases coexist with endometriosis depending on the common immunologic characteristics such as Tumor necrosis Factor (TNF) and the helper T cell (Th17) pathway. Yin et al., from Taiwan, published a retrospective cohort study titled “Risk of Ankylosing Spondylitis in Patients With Endometriosis: A Population-Based Retrospective Cohort Study” in the journal named  Frontiers in Immunology. The…

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The association between inflammatory cytokines and fertility in women with endometriosis

Women with endometriosis suffer not only from a broad spectrum of symptoms including pain including dysmenorrhea, dyspareunia, and chronic pelvic pain but also fertility problems. Endometriosis-associated infertility develops depending on a combination of several mechanisms such as distorted pelvic anatomy, impaired ovarian function, altered microenvironment, affected endometrial receptivity, and embryo quality. However, we still couldn’t understand which endometriosis patient would develop infertility. Jin et al,  from China and Germany, published a study titled “Infertile women with endometriosis possess differences in…

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Does endometrioma affect ovarian reserve to reach pregnancy and birth?

Endometrioma occurs in approximately 17-44% of women with endometriosis. These women suffer from dysmenorrhea, dyspareunia, chronic pelvic pain, and also infertility. Although the exact mechanism explaining endometriosis-associated infertility has not been elucidated, distorted pelvic anatomy, impaired ovarian function, altered microenvironment-endometrial receptivity, and embryo quality has been accepted as the most common responsible mechanisms. In vitro fertilization treatments can be performed for the management of infertility in women with endometrioma. It has been known that clinical pregnancy and live birth rates were…

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Abdominal wall endometriosis is not a rare disease as supposed

Abdominal wall endometriosis is an iatrogenic type of endometriosis defined as the localization of endometrial glandular and stromal tissue on the abdominal wall including skin, the rectus abdominis muscle, and rectus muscle sheath. Cyclical pain, mass located on the abdominal wall, and a history of cesarean section or gynecologic procedures represent the classic triad of abdominal wall endometriosis. Surgical removal with negative surgical margins remains the gold standard management while medical treatment is not effective because of the connective tissue around…

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Listening to patients’ complaints is the first step on the way to a diagnosis of endometriosis.

Early diagnosis and management of endometriosis are not possible due to the wide spectrum of symptoms and absence of non-invasive diagnostic biomarkers. Particularly the adolescent population is at risk for the diagnostic delay because pelvic pain and dysmenorrhea are very common among adolescent girls. Wrobel et al, from Poland, published a study titled “Diagnostic delay of endometriosis in adults and adolescence-current stage of knowledge” in the journal named Advances in Medical Sciences. The authors aimed to evaluate the recent status of the…

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The underlying reason of implantation failure in women with endometriosis-associated infertility

Endometriosis is most frequently encountered in reproductive-aged women, with a prevalence of 10-15% in the general population. However, endometriosis is more frequently diagnosed in infertile women, with a prevalence of 25-40%. Although the exact mechanism explaining the association between endometriosis and infertility has not been elucidated, distorted pelvic anatomy, impaired ovarian function, altered microenvironment, affected endometrial receptivity, and embryo quality has been accepted as the most common responsible mechanisms. Besides fertility problems, women with endometriosis may encounter recurrent implantation failures during…

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Is "non-hormonal therapy" effective in women with endometriosis-associated pain?

Women with endometriosis require effective treatment due to the negative impact of the disease on quality of life. Hormonal treatments including oral contraceptives, and progestins are usually recommended to suppress ovulation and decrease pelvic pain. However, some women do not use these hormonal drugs regularly due to the side effects, while others are resistant to these drugs or inconvenient to use them. They continue to suffer from endometriosis-associated pain and seek other therapeutic options. Dr. DiVasta et al, from Harvard,…

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The consequences of endometriosis on the quality of life

The most common clinical findings of endometriosis patients are pelvic pain and fertility problems, resulting in impairment of quality of life. These women are affected especially during the menstruation period. Olliges et al., from Germany and Switzerland, published a study titled “The Physical, Psychological, and Social Day-to-Day Experience of Women Living With Endometriosis Compared to Healthy Age-Matched Controls—A Mixed-Methods Study” in the journal named as Frontiers in Global Women’s Health. In the study, the authors aimed to evaluate pain ratings…

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Is intrauterine insemination effective in women having endometriosis-associated infertility?

The most common presenting complaints of women with endometriosis are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Affected women demand therapy for these symptoms of endometriosis, notably fertility problems. Several underlying mechanisms have been proposed to explain endometriosis-associated infertility including anatomic distortion, diminished tubal peristalsis, diminished sperm movements, dysfunctional folliculogenesis, luteal phase dysfunction, and alterations in endometrial receptivity. In vitro fertilization or intracytoplasmic sperm injection techniques have been preferred in women with moderate or severe endometriosis while intrauterine insemination with or…

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Pain alone is not a specific predictor for endometriosis diagnosis

The most common symptoms and signs of women with endometriosis include dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. However, diagnostic delay still occurs due to the broad clinical spectrum of the disease and the absence of non-invasive diagnostic biomarkers. Gordon et al., from Australia, published a study entitled “When pain is not the whole story: Presenting symptoms of women with endometriosis” in the journal "Australian and New Zealand Journal of Obstetrics and Gynaecology". The authors sought to evaluate the causes for…

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The higher the Endometriosis Fertility Index, the higher the chance of getting pregnant

The women who desire to get pregnant may also suffer from fertility problems depending on several mechanisms such as anatomic distortion, peritoneal adhesions, tubal dysfunction, impaired quality of oocytes, and impaired endometrial receptivity. One of the most important problems in women with fertility desire is whether they can get pregnant after endometriosis surgery or not. Rodrigues et al. from Brazil published a study titled “Endometriosis fertility index predicts pregnancy in women operated on for moderate and severe symptomatic endometriosis” in…

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Placenta praevia and cesarean section more common in patients with ART for Endometriosis

Even though endometriosis is known to be associated with infertility, these women still have a chance to get pregnant spontaneously or by assisted reproduction techniques (ART) with the aid of recent technological developments. A It has also been shown that endometriosis patients are likely to experience poor obstetric outcomes. Ribot et al, from France, recently published a retrospective study entitled “Pregnancy outcomes after in vitro fertilization for moderate and severe endometriosis. A case-control study” in the 'Journal of Gynecology Obstetrics…

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Endometriosis and women’s social lives, work and education.

The women with endometriosis present with a broad clinical spectrum including pelvic pain, dysmenorrhea, dyspareunia, and infertility. All of these symptoms and signs may have a negative impact on women’s lives by having endometriosis. Mastrangelo and Turnbull, from Australia, published a retrospective study titled “The impact of surgically diagnosed symptomatic endometriosis on women’s social lives, work and education: An inductive classical content analysis” in the journal named "The Australian and New Zealand Journal of Obstetrics and Gynaecology". The authors aimed…

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Preoperative Neutrophil-to-Lymphocyte Ratio for prediction of postoperative pregnancy

Among women with endometriosis, 30 to 50 percent are estimated to have infertility, and 25-50% of infertile patients are found to have endometriosis. Anatomic distortion, diminished tubal peristalsis, diminished sperm movements, dysfunctional folliculogenesis, luteal phase dysfunctions, and alterations in endometrial receptivity have been proposed as the underlying mechanisms of endometriosis-associated infertility. Several classification systems have been developed to identify the severity of endometriosis, but pregnancy outcomes could not be predicted using these systems. Endometriosis Fertility Index (EFI) could only be…

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Environmental factors play a role in the development of endometriosis

The proposed mechanisms underlying the development of endometriosis may be classified into three groups: in-situ theory, implantation theories, and induction theories. Genetic, hormonal, environmental, and lifestyle-related factors are also involved as no mechanism is solely responsible for endometriosis development. Although there are several papers in the literature about the effect of ecological factors on endometriosis development, contradictory conclusions are encountered. Polak et al. from Poland published a review titled “Environmental Factors and Endometriosis” in the journal named "International Journal of Environmental Research…

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How does adenomyosis affect IVF outcomes?

Adenomyosis is defined as the localization of endometrial tissue in the muscle layer of uterus. Several theories have been proposed to explain the reasons of adenomyosis-associated infertility including uterine dysperistalsis, abnormal transportation of sperm in the uterine cavity, and embryo implantation. In vitro fertilization (IVF) treatment, especially with the pretreatment of long-acting GnRH agonist, has been considered as the most common option to overcome infertility due to adenomyosis. Zhang et al, from China, published a study titled “Impact of Uterine…

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The comparison of the effect of hemostatic techniques on ovarian reserve during endometrioma cystectomy

The possible negative effect of the surgical excision of endometriomas on the ovarian reserve has brought up the meticulous implementation of the decision for surgical approach. Dr. Raquel Silveria da Cunha Araujo et al, from Brazil, published a study titled as “Ovarian function following use of various hemostatic techniques during treatment for unilateral endometrioma: A randomized controlled trial” in the "International Journal of Gynecology and Obstetrics". The authors sought to evaluate the effect of different hemostatic techniques, namely bipolar energy, hemostatic…

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Persistence of Chronic Pelvic Pain after Hysterectomy

Chronic pelvic pain is defined as the "pain in the pelvic area that lasts for 6 months or longer". There are several gynecological, urological, and gastrointestinal reasons for the development of chronic pelvic pain. Nociceptive pain or central sensitization is the type of pain mechanically different from nociceptive pain which is caused by inflammation or tissue damage, or neuropathic pain that results from nerve damage. The causes are not fully understood but it is thought to be a dysfunction of…

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Impact of surgery before IVF in infertile women with endometrioma

Among the women with endometriosis, 30 to 50% are estimated to have infertility. On the contrary, among women who present with infertility, 25 to 50% are estimated to also have endometriosis. Several mechanisms have been proposed to explain the association between endometriosis and infertility, including anatomic distortion, diminished tubal peristalsis, diminished sperm movements, dysfunctional folliculogenesis, luteal phase dysfunction, alterations in endometrial receptivity. Although the most common treatment modalities for infertility in endometriosis patients are surgical removal of endometriomas and/or IVF…

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